Women with probable migraines suffer from more frequent, more severe, and higher-impact headaches when compared with men, according to a study published in Headache. Researchers analyzed the sex differences associated with prevalence, intensity, impact, and comorbidities of headaches in patients with migraines and probable migraines. Data were collected from adults who participated in the Korean Headache-Sleep Study. Three-part questionnaires were completed during face-to-face interviews, and data were collected on demographic information, socioeconomic characteristics, headache profiles, sleeping patterns, and comorbidity occurrences.

Migraines were diagnosed based on characteristics in the Third Edition of the International Classification of Headache Disorders (ICHD-2), and if all the criteria for migraines were not met, the patient was diagnosed with probable migraines. The Goldberg Anxiety Scale was used to diagnose anxiety; the Patient Health Questionnaire-9 was used to diagnose depression; the visual analog scale was used to assess headache intensity; and the Headache Impact Test-6 was used to assess quality of life.

Of the 2695 patients who completed the survey, 107 women and 36 men were diagnosed with migraines, and 243 women and 136 men were diagnosed with probable migraines.  Women were significantly more likely to be diagnosed with migraines (7.9% vs 2.7%, P <.001) and probable migraines (18% vs 10.1%, P <.001) than men.

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For women diagnosed with migraines, the prevalence peaked at 10.6% between 30-39 years of age and was the lowest at 5.6% between 50-59 years of age. For women diagnosed with probable migraines, the prevalence peaked at 22.3% between 40-49 years of age and was the lowest at 12.8% between 50-59 years of age. For men diagnosed with migraines, the prevalence peaked at 4.2% between 40-49 years of age and was the lowest at 1.0% between 60-69 years of age. For men diagnosed with probable migraines, the prevalence peaked at 12.6% between 30-39 years of age and was the lowest at 6.1% between 60-69 years of age.

Women with probable migraines experienced a higher headache frequency per month (median [interquartile range]; 1.0 [0.3–3.0] vs 0.8 [0.3–2.0], P =.037), a higher median score on the visual analog scale for intensity (5.0 [4.0–7.0] vs 5.0 [3.0–6.0], P =.019), and a higher median score on the Headache Impact Test-6 (47.0 [42.0–54.0] vs 44.0 [42.0–51.8], P =.013) when compared with men. In regards to clinical presentations, women diagnosed with probable migraines experienced more nausea than men (90.5% vs 76.5%, P <.001). Future studies need to increase participation rate to increase statistical power, include migraine sub-classifications to account for clinical impact, and include the potential for current headache treatment that could reduce symptoms of headaches and impact quality of life.

In conclusion, sex differences were found among the cohort experiencing probable migraine, with women having a higher prevalence, more frequent, more severe and higher impacting headaches when compared with men. The researchers concluded that “women with [probable migraine] need more intensive evaluation and treatment than men with [probable migraine].”

Two authors declared affiliation with multiple pharmaceutical companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Song TJ, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Sex differences in prevalence, symptoms, impact, and psychiatric comorbidities in migraine and probable migraine: a population-based study [published online January 9, 2019]. Headache. doi: 10.1111/head.13470